Apalutamide has shown significantly increases in radiographic progression-free survival (rPFS) and overall survival (OS) in metastatic hormone-sensitive prostate cancer (mHSPC) patients diagnosed by conventional imaging (CI). However, there is scarce knowledge on the use of apalutamide in mHSPC population diagnosed by NGI.
Retrospective multicenter study of mHSPC patients treated with apalutamide from May 2018 to September 2023 registered in the Real-World Evidence APA (RWE-APA). CI and NGI group were defined, according to the diagnostic tool of metastatic disease. Primary objective was rPFS at 24 months in CI vs NGI group. Secondary objectives were OS in CI vs NGI group and rPFS in synchronic/metachronic, low volume (LV)/high volume (HV) in CI and NGI groups and risk of developing new metastasis according to the imaging technique, metastasis volume and location of the metastasis.
772 mHSPC patients were included. 47% (359) of patients were diagnosed with CI and 53% (413) of patients with NGI. rPFS at 24 months was 80% in the CI group vs 84% in the NGI group (Hazard ratio (HR): 0.57 (0.35 - 0.92) 95% Confidence Interval [CI], p = 0.023). OS at 24 months was 89.5% in the CI group and 95.8% in the NGI group (HR 0.35; 95% CI, 0.16 - 0.75, p = 0.007). In the multivariable analysis, only HV was significantly associated with metastatic progression (HR 0.33 (0.18-0.59) 95% CI; p < 0.001).
mHSPC patients treated with apalutamide and NGI-diagnosed exhibited superior rPFS and OS in comparison with CI-diagnosed patients.
Actas urologicas espanolas. 2025 Mar 15 [Epub ahead of print]
M Hassi Roman, K Mate, P de Pablos-RodrIguez, Á Zamora Horcajada, A Guijarro Cascales, Á Sanchís Bonet, A Vilaseca, D Vázquez-Martul Pazos, E Linares Espinós, J Muñoz Rodríguez, J M de la Morena Gallego, J R Alemán, J Gómez Rivas, L Formisano, M J Juan Fita, M Costa Planells, M Domínguez Esteban, M Pérez Márquez, M García Sanz, N García Expósito, N Picola, P Servian Vives, R Sopeña Sutil, M A Climent Durán, M Ramírez Backhaus
Hospital DIPRECA, Santiago, Chile. Electronic address: ., Hospital-Clínica y Centro de Traumatología Péterfy Sándor Utcai, Budapest, Hungary., Instituto Valenciano de Oncología, Valencia, Spain., Hospital Palencia, Palencia, Spain., Hospital Universitario Fundación de Alcorcón, Madrid, Spain., Hospital Príncipe de Asturias, Madrid, Spain., Hospital Clínic de Barcelona, Barcelona, Spain., Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain., Hospital Universitario La Paz, Madrid, Spain., Hospital Parc Taulí, Sabadell, Spain., Hospital Universitario Infanta Sofía, Madrid, Spain., Hospital Verge de la Cinta de Tortosa, Tortosa, Tarragona, Spain., Hospital Clínico San Carlos, Madrid, Spain., Departamento de Medicina Clínica y Cirugía, Universidad Federico II, Nápoles, Italy., Hospital Vall d'Hebrón, Barcelona, Spain., Hospital Universitario Marqués de Valdecilla, Santander, Spain., Consorci Sanitari de Terrassa, Barcelona, Spain., Hospital León, León, Spain., ICO Hospitalet, Barcelona, Spain., Hospital Universitari de Bellvitge, Barcelona, Spain., Hospital Universitari Germans Trias i Pujol, Barcelona, Spain., Hospital Universitario 12 de Octubre, Madrid, Spain.